title: Parental behaviour in paediatric chronic pain: a qualitative observational study.
abstract: OBJECTIVE
  Parental behaviour appears to influence the adjustment of children with chronic pain. However, research in this area has failed to produce consistent evidence. Studies have tended to rely on self-report measures derived from adult pain populations. This qualitative, observational research provides descriptive data of parental behaviour in a clinical environment.
  
  
  METHODS
  A qualitative observational study was made of parents and adolescents in a physically stressful setting. Modified grounded theory was used to analyse verbal and non-verbal behaviours.
  
  
  METHODS
  Eight parent-adolescent dyads seeking treatment for chronic pain were videoed during physical exercise sessions. Verbal and non-verbal behaviours were recorded and transcribed.
  
  
  RESULTS
  Four overarching categories emerged: 'monitoring', 'protecting', 'encouraging' and 'instructing'. These often had both verbal and non-verbal aspects. Within these categories, more precise behavioural groups were also identified.
  
  
  CONCLUSIONS
  This research identifies categories of parental behaviour that were derived directly from observation, rather than imposed on the basis of results from different populations. Four categories of behaviour were derived, which clarify and extend dimensions used in existing self-report instruments. Careful description of parental behaviours showed features that past research has neglected, and highlighted potential drawbacks of apparently positive parental actions.
authors.affiliation: Bath Centre for Pain Services, Royal National Hospital for Rheumatic Diseases NHS Foundation Trust, UK Centre for Pain Research, University of Bath, UK.
authors.forename: Emma
authors.initials: E
authors.lastname: Dunford
authors.affiliation: Bath Centre for Pain Services, Royal National Hospital for Rheumatic Diseases NHS Foundation Trust, UK.
authors.forename: Miles
authors.initials: M
authors.lastname: Thompson
authors.affiliation: Bath Centre for Pain Services, Royal National Hospital for Rheumatic Diseases NHS Foundation Trust, UK Centre for Pain Research, University of Bath, UK jeremy.gauntlett-gilbert@rnhrd.nhs.uk.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Gauntlett-Gilbert
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D002648:Child; D059350:Chronic Pain; D005260:Female; D006801:Humans; D008297:Male; D010287:Parent-Child Relations; D016487:Parenting / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D036301:Qualitative Research
keywords: Parental behaviour; adolescents; chronic pain; grounded theory; observational; qualitative